Claims Analyst

Free Market Health; Pittsburgh (Allegheny County); On-site; USD 55,000 - 85,000; Full time

Benefits offered by this job

Generous PTO

100% employer-paid individual medical,

dental, and vision premiums

Employer HSA contribution

Paid parental leave

401(k) match

Transportation and parking benefits

Flexible, collaborative work enviro n

Job summary

Free Market Health is seeking a detail-oriented Claims Analyst to join our team onsite at our Pittsburgh Headquarters. You will monitor claims clearinghouse activity, validate claims, identify discrepancies, and help resolve issues affecting payment accuracy and the overall claims experience.

You’ll collaborate with Pharmacy Operations and Client Services to answer questions, monitor trends, and maintain HIPAA-compliant handling of healthcare data while contributing to timely, accurate claim

Qualifications

• 2+ years of experience with healthcare claims and related transactions.
• Knowledge of pharmacy billing, coding, or claims processing.
• Experience working with X12 and NCPDP transaction formats.
• Strong attention to detail and ability to monitor multiple priorities.
• Clear communication and collaboration across teams.
• Sound problem-solving skills and HIPAA compliance.

Responsibilities

• Review and reconcile claims submitted through the claims clearinghouse to confirm receipt by payers.
• Review claims for payment accuracy based on processing rules.
• Identify denied or inaccurately paid claims and support follow-up and resolution.
• Partner with Operations, Client Services, and other teams to answer claim questions.
• Monitor daily claims activity and identify issues or process gaps.
• Support revenue integrity and a high-quality client/patient experience.
• Maintain confidentiality of sensitive health information per HIPAA.
• Assume additional responsibilities to support team priorities.

Skills

Healthcare claims

Pharmacy billing

X12

NCPDP

Attention to detail

Communication

Problem solving

HIPAA compliance

Education

College degree preferred

Tools

SQL

Job description

Why FMH

Every day, someone receives a life-changing diagnosis. Getting the right medication should be straightforward - but too often it isn’t.

Specialty medications move through a complex network of providers, health plans, pharmacies, and manufacturers. Administrative delays, disconnected systems, and limited visibility can slow treatment when time matters most.

Free Market Health exists to make that process work better.

Our technology connects stakeholders across the specialty pharmacy ecosystem, helping prescriptions reach the right pharmacy while improving visibility, reducing friction, and keeping treatment moving forward for the patients who depend on them. We focus on the most important stakeholder of all: the patient.

Free Market Health is seeking a detail-oriented Claims Analyst to join our team onsite at our Pittsburgh Headquarters. This role will help ensure the accuracy, integrity, and timely processing of our claims. In this role, you will monitor clearinghouse activity, validate claims, identify discrepancies, and help resolve issues that impact payment accuracy and the overall claims experience.

This is a strong opportunity for someone who enjoys working with healthcare claims data, partnering across teams, and using problem-solving skills to support accurate, efficient claims operations.

What You’ll Do

• Review and reconcile claims submitted through the claims clearinghouse to confirm successful receipt by payers.
• Review claims for payment accuracy based on applicable processing rules.
• Identify denied, rejected, or inaccurately paid claims and support timely follow-up and resolution.
• Partner with Pharmacy Operations, Client Services, and other internal teams to answer claim-related questions and communicate when action is needed.
• Monitor daily claims activity and proactively identify issues, trends, or process gaps that may impact accuracy or operational performance.
• Support accurate claims outcomes, revenue integrity, and a high-quality experience for clients and patients.
• Maintain confidentiality and protect sensitive healthcare information in accordance with HIPAA and company expectations.
• Take on additional responsibilities as needed to support the team and business priorities.

What We’re Looking For

• 2+ years of experience with healthcare claims and related transactions.
• Knowledge of pharmacy billing, coding, or claims processing.
• Experience working with X12 and NCPDP transaction formats.
• Strong attention to detail and ability to monitor significant claim volume while managing multiple priorities.
• Clear communication skills and the ability to work collaboratively with cross-functional teams.
• Sound problem-solving skills, including the ability to identify issues, determine root causes, and follow through on resolution.
• Ability to handle sensitive healthcare information with professionalism and discretion.

Nice to Haves

• SQL knowledge or experience using data to research and resolve claims-related issues.
• College degree preferred, but not required.

Life at FMH

We’re building more than a company. We’re building a team of ambitious, curious people who are passionate about solving meaningful problems, growing their careers, and genuinely enjoying the journey together.

Based in Pittsburgh’s Strip District, FMH draws inspiration from the city we call home. Our value of Grit isn’t just a word on a wall. It’s a mindset inspired by the city around us: showing up, rolling up our sleeves, and finding a way forward no matter the challenge.

As FMH continues to grow, so do the opportunities for our people to leave their mark. Guided by our core values of Integrity, Adaptability, Grit, and Collaboration, we foster an environment where trust is earned, new ideas are welcomed, challenges are embraced, and success is shared. You will be surrounded by people who care deeply about the work they do and the people they do it with.

Together, we’re building something special, and we’re just getting started.

Benefits

• Generous PTO
• 100% employer-paid individual medical, dental, and vision premiums
• Employer HSA contribution
• Paid parental leave
• 401(k) match
• Transportation and parking benefits
• Flexible, collaborative work environment

Benefit eligibility is based on employment status.

Build What’s Next With Us

Healthcare is evolving - and so are we. If you’re excited by meaningful challenges, collaborative teammates, and the opportunity to help build a growing healthcare technology company, we’d love to hear from you.

Equal Opportunity Employer

Free Market Health is proud to be an Equal Opportunity Employer.

We believe that a diverse and inclusive workplace makes us better teammates and problem solvers and we encourage all qualified individuals to apply. Employment decisions are based on business needs, qualifications, and merit.

FMH is also committed to providing reasonable accommodations throughout the hiring process. If you require assistance or accommodation due to a disability, we will work with you to meet your needs.